Significant clinical impact of immunosuppressive therapy termination after allogeneic haematopoietic stem cell transplantation

The clinical impact of immunosuppression termination (IST) after allogeneic haematopoietic stem cell transplantation (allo-HSCT) remains to be fully elucidated. This study was aimed at assessing the impact of IST within 2 years after transplantation on subsequent clinical outcomes. We analysed data for patients from the Transplant Registry Unified Management Program 2 (TRUMP 2) database who survived without progression for at least 2 years after allo-HSCT. Of the 5061 patients whose median age was 48 (range: 0-79) years, 2320 discontinued immunosuppressive therapy within 2 years (IST group), while 2741 did not (non-IST group). The 4-year overall survival (OS) rate was significantly higher in the IST group than in the non-IST group (95.3% vs. 90.8%; p < 0.01). The 4-year cumulative incidence of non-relapse mortality (NRM) was significantly lower in the IST group than in the non-IST group (3.5% vs. 8.6%; p < 0.01). This reduction in NRM was consistent across major causes, including graft-versus-host disease (GVHD)-related mortality, infection-related mortality and organ failure-related mortality. Immunosuppressive therapy beyond 2 years after allo-HSCT was associated with inferior OS. Our findings suggest that the optimal transplant strategy is necessary to avoid long-term immunosuppression for improving clinical outcomes in allo-HSCT recipients.

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Publication Details

Journal
British Journal of Haematology
Published
2026-03-22
DOI
https://doi.org/10.1111/bjh.70450
Primary Topic
Hematopoietic Stem Cell Transplantation
Type
article
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article

Significant clinical impact of immunosuppressive therapy termination after allogeneic haematopoietic stem cell transplantation

Mamiko Sakata‐Yanagimoto, Yuta Hasegawa, Noboru Asada, Masataka Ishimura et al.
British Journal of Haematology
Hematopoietic Stem Cell Transplantation
article

Significant clinical impact of immunosuppressive therapy termination after allogeneic haematopoietic stem cell transplantation

Mamiko Sakata‐Yanagimoto, Yuta Hasegawa, Noboru Asada, Masataka Ishimura, Kimikazu Yakushijin, Akihiro Ohmoto, Makoto Onizuka, Moeko Hino, Noriko Doki, Masashi Sawa, Yoshinobu Kanda, Naoyuki Uchida, Masatsugu Tanaka, Takahiro Fukuda, Yuho Najima, Tetsuya Nishida, Kazuki Yoshimura, Koji Kawamura, Yoshiko Atsuta, Shigeo Fuji
article en

Abstract

The clinical impact of immunosuppression termination (IST) after allogeneic haematopoietic stem cell transplantation (allo-HSCT) remains to be fully elucidated. This study was aimed at assessing the impact of IST within 2 years after transplantation on subsequent clinical outcomes. We analysed data for patients from the Transplant Registry Unified Management Program 2 (TRUMP 2) database who survived without progression for at least 2 years after allo-HSCT. Of the 5061 patients whose median age was 48 (range: 0-79) years, 2320 discontinued immunosuppressive therapy within 2 years (IST group), while 2741 did not (non-IST group). The 4-year overall survival (OS) rate was significantly higher in the IST group than in the non-IST group (95.3% vs. 90.8%; p < 0.01). The 4-year cumulative incidence of non-relapse mortality (NRM) was significantly lower in the IST group than in the non-IST group (3.5% vs. 8.6%; p < 0.01). This reduction in NRM was consistent across major causes, including graft-versus-host disease (GVHD)-related mortality, infection-related mortality and organ failure-related mortality. Immunosuppressive therapy beyond 2 years after allo-HSCT was associated with inferior OS. Our findings suggest that the optimal transplant strategy is necessary to avoid long-term immunosuppression for improving clinical outcomes in allo-HSCT recipients.

British Journal of Haematology
Tokai University (JP), Jichi Medical University (JP), Chiba University (JP), Aichi Medical University (JP), Kanagawa Prefectural Hospital Organization (JP), Tokyo Metropolitan Komagome Hospital (JP), Kobe University Hospital (JP), Kyushu University Hospital (JP), Okayama University Hospital (JP), University of Tsukuba Hospital (JP), Japanese Red Cross Nagoya Daiichi Hospital (JP), Hokkaido University Hospital (JP), Anjo Kosei Hospital (JP), Osaka International Cancer Institute (JP), The Japanese Data Center for Hematopoietic Cell Transplantation (JP), Jichi Medical University Saitama Medical Center (JP), Toranomon Hospital (JP), Japanese Foundation For Cancer Research (JP), Kanagawa Cancer Center, Tottori University (JP)
Good health and well-being
Openalex Percentile: Top 12%
Hematopoietic Stem Cell Transplantation
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